Evidence-based Practice Project Proposal
Nursing Practice Concern/Problem
Generally, a lot of attention is directed towards patients with a more significant medical need. The area of interest in this project proposal is patients that are an inpatient in critical care settings. The wellbeing of patients in the intensive care unit (ICU) echoes profound collaborative care to necessitate efficiency and quality by health professionals; collaboration, participation, and principles of self-care are exclusively promoted. Nevertheless, the problem with the practice is that paper documenting leads to errors in charting, decreasing quality care (due to more time spent on documenting), and adverse patient outcomes.
Without a doubt, my postgraduate MSN degree in the clinical nursing field has given me the upper hand to advance my career opportunity and income with the exclusive expense, effort, and significant time. In the event of practice, producing unquestionable results is often not an easy thing. Limitations do exist fundamentally. For instance, the use of a single standardized clinical scenario had signaled a randomized problem in US-based physicians. The unusual situation interfered with the group inferences on the prognosis directed at the patients.
The life endangered patients have a substantial better survival chance if guaranteed with the professional assessments and measurements. The intensive care medicine, introduced in the 1950s, periodically evolved over the decades in a series of postanesthesia and operating rooms, superseding the conventional observational methods (Chandrasekhar et al., 2017). This background information is based on irrefutable scientific data incorporated by electronic techniques of measurements and quantitative monitoring.
PICOT Question
In a critical care setting (P), does the implementation of a clinical information system (I) vs. automatic charting (C) or the use of an antiquated system decrease the time (O) nurses spend on documentation of care over an 8week period (T)?
Key Stakeholders
In the hospitals, the available resources have been channeled to provide adequate care through budgeting funds with the help of various stakeholders. Nurses, therefore, have appealed for capable hospital equipment to address proper working conditions and enhance clinical treatment procedures that promote a positive experience. Though the most critical stakeholders, nurses have and are fervently working to include several roles that aid in alleviating the proficient intensive care to underprivileged patients. Therefore, in the bigger picture, nurses are as essential as other professionals in delivering intensive care. According to (Adereti et al., 2019), nursing documentation offers high quality in delivery via paper-based documentation and electronic form.
Additionally, physicians and nursing educators play an essential role in evaluating interventional proposals for the intensive care documentation system. For instance, these stakeholders will hypothetically assess providers in intensive settings most likely to document the prognosis of patients and a futuristic time disclose the findings as well (Turnbull et al., 2019). Aside from that, IT has overtaken the healthcare world to emerge out as a principal life-changing factor. The internet of Things plays a crucial role in enabling healthcare providers to substantially deliver improved care in different electronic forms to patients, designed just for critical care (Carayon et al., 2015). Favorable anticipations are not dependable on the action proposed by nursing educators, but the emotional influence displayed by the patient is of fundamental importance. This notion implies that positive results are only achieved if the patient expects to recover from intensive care.
Theoretical Framework
Basically, the most important thing to put into consideration is the structure and culture of the organization. This is achievable through efficient communication of the proposed solution to all the internal and external stakeholders of the institution as well as a comprehensive change management process to facilitate the suitable introduction of quality care within the organization. Communication can assist in the preparation of the stakeholders to adopt the changes associable with the implementation of health care (Lucas et al., 2019). The theoretical framework here includes the organizational culture of physicians, nurses, and Medicare facilities. Based on this framework, process estimation results suggest that the development intervention methods are successful in establishing low-cost theory-based intensive care that fully engaged patients to be part of the system. This can be done by obtaining a full medical history of the patient and carrying out a comprehensive medication reconciliation that identifies the drugs that the patient has been using and the medications that may have adverse reactions on the patient (Cleveland, Motter, & Smith, 2019). The second theoretical measure relates to the training of staff on approaches to take during delivery care. Most of the errors that make a place at this stage compared to the administration of medication to the wrong patient, using the wrong route of administration, administering the wrong assessments, or providing irrelevant findings as well as documentation of incorrect results. To avoid these errors, interventions required include educating nursing staff in identifying the patient’s backgrounds, confirming patient identity from two valid patients identifies and communicating with the patient regarding medication side effects and indications. On the other hand, education interventions are as crucial in gathering as much detailed information on the cultural relevance of patients’ historicity.
Literature Review
The historicity of patients’ detailed information is a primary factor in the providence of medical care. In healthcare settings, the need to address medication is significant, particularly in the monitoring of patients. The high rate of medication errors produces imperative results that raise attention in healthcare delivery. Among the most effective based on evidence-based practice is to be more vigilant in the prevention of acute services during the admission of the patient. Therefore report based assessments provide healthcare measures enhanced by quality care. Cost factors and healthcare of patients require a reduction of timely and untimely documentation (Ahn et al., 2016), especially in these hospitals that have massive prevalence. It is clear that retrospective study is easily monitored and guarantee extracted documentation by addressing factors like the diversity of the places visited by the patient, the unique number of areas and the number of the significant sites visited provide a robust framework to creative analyze the significant hospitals EMR records. In other words, these factors are extremely fundamental in the attainment of quantified ICU data, prospective research, and determination of ICU workflow (Cleveland, Motter, & Smith, 2019).
Data Collection Methods
This study was conducted using primary sources and central data collection methods and analyzed by graphical means. For instance, audio recordings, face to face interviews, and sample participants were used as primary methods of collecting data. Also, documented information of patients and nurse volunteers were used to provide secondary information concerning the patient’s prognosis. The primary data collection method, which is audio recordings, was used to examine inferences in ICU patients, stay and assess the probable cause that could assist in EHR implementation. This approach mainly boosts the morale of patients and serves as a contributing factor in recovery and induces patient responsibility for their health status. Conclusively, the study revealed that the implementation significantly demonstrated a broad distribution in the workflow of providers. Contrary to audio recordings, face to face interviews aided in collecting essential information since short answer questionnaire were used to explain the quality of nursing documentation (Adereti et al ., 2018). The research addresses that respondents can provide accurate information since the scenario is based on conciseness and relevant information based on sincerity. In the case of interviews used to parents ( AkhuZaheya et al., 2017) reckon that parents are subject to providing accurate data via electronic-based documentation.
Additionally, several methods are applicable to achieving the desired outcomes of the problem solution. Important to talk about here is the need to ensure that the healthcare staff undergoes training to understand and appreciate the implications of the training they are receiving. This will improve their dedication and commitment to the training program, thus increasing the probability of achieving the outcomes. It is also necessary to provide the nurses with the required resources to facilitate practical training and development. This can ensure that they are in a position to apply what they have learned in real-life practical applications of the medication administration to patients. Among the significant barriers to achievement of the outcomes is the time constraint that healthcare staff is under due to the nature of their jobs. To address this, it is recommendable that training takes place for nurses in small groups in order to ensure the smooth operation of the healthcare institution. Insufficient resources for training may also pose a problem in the implementation of the solution (Wong et al., 2017). This can be addressed by preparing a budget for the program and adhering to it as well as encouraging resource sharing during the training sessions.
Analysis
The primary data analysis approach was through various methods divided by secondary and primary segments. Primarily, audio recordings, face to face interviews, and data obtained from physicians, nurses, and IT experts were analyzed through graphical and electronic methods. Audio recordings were analyzed through transcription and documented, while questionnaires were analyzed through tallying and grouping of statistical data. Graphs were constructed to compare the results of information given by parents and that provided by results concerning intensive care in clinical settings that have patients with chronic illnesses (Bowen et al., 2017). Recorded data constructed from observation was analyzed and compared with electronic sources from IT databases in hospitals. Further, the information which outlined information difference in the IT department and what respondents gave was analyzed. Participants involved in the face to face interview were required to fill the short-answer questionnaire. Therefore, information eligibility in this segment was addressed from the information provided by the two sources. However, participants were allowed to answer questions at their own will because sensitive information was concealed. Participants who did not feel like solving specific issues were not required to answer. Documented analysis from the questionnaire and audio recordings were also achieved based on how they were conducted.
Expected Outcomes
Results from this information were compared by the health results established in hospital computer databases. It was discovered other patients failed to reveal practical details linking them to their appropriate health status. Consultations were later conducted with physicians, nurses, and IT personnel, and it was gathered that patients refused to reveal their real health identity due to various factors ( Adereti et al., 2019). The outcomes of the proposed solution are likely to have several impacts on multiple indicators. With regard to the quality of care, the consequences may result in an improvement in the quality of healthcare that patients in the organization receive, which translates into higher levels of patient satisfaction. The efficiency of processes is also likely to improve due to an improvement in the efficiency of healthcare staff. This may have a positive impact on the cost-efficiency of the organization as well as the risk management of the institution, as the interventions will reduce medication errors and the costs associable with managing such errors. The professional expertise of healthcare workers may also improve due to the acquisition of critical knowledge and skills regarding medication administration. With the effective implementation of the proposed solution, the outcomes expected from the interventions are positive. The primary outcome will be a reduction in the rate of medication errors in the hospital. This is associable with the likelihood that the interventions may improve the efficiency of healthcare staff in the administration of the new medication procedure.
A different outcome expected is an improvement of the health of patients treated using the medication procedure due to greater accuracy and efficiency of intensive care. In order to reduce the high rate of medication errors occurring in US healthcare organizations, it is imperative to consider the use of several education-based interventions that can optimize the safety and quality of care provided by healthcare staff (Carayon et al., 2015). Additionally, there is also a need to address medication problems related to the monitoring of medication effects. For instance, a healthcare worker may fail to check vital signs after administration of medicine or may check but not react to them. To address this problem, it is important to train healthcare staff in order to enhance their ability to detect common adverse effects of medications in patients as well as establish protocols that facilitate an effective response to the reactions. Furthermore, training of healthcare workers to monitor the effectiveness of medications administered, such as checking the vital signs, carrying out electrocardiograms, and assessing lab results, can improve the efficiency of staff in medication administration and thus reduce errors.
References
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